Heart Failure Care Plans

What is a Heart Failure Care Plan?

The Heart Failure Care Plan is a condition-specific care planning and assessment tool designed to support care teams in delivering personalised care for patients with heart failure.

The solution integrates seamlessly with the Graphnet Shared Care solution, offering a holistic view of both condition-specific and general care needs.

It supports:

Clinicians to access real-time data entered directly into Graphnet's Personal Health Record (PHR).
Patients to view their care plans within the PHR app, encouraging proactive engagement.

Data can be manually updated during consultations, providing a comprehensive record of the patient’s condition. Specific heart failure medications can be recommended for prescription or discontinuation. Primary care teams can review and act on these recommendations.

Key Benefits of the Heart Failure Care Plan

Accurate, Real-Time Information in One Place: The care plan consolidates contributions from all care providers into the shared care record ensuring real-time availability of patient data and accessibility for emergency and out-of-hours care teams.
Time Savings: Authorised users can access key details including heart failure history, medication, results and ongoing progress.
Personalised Care: By offering a complete view of the patient, care teams can adapt treatment plans to meet individual needs effectively.

Key Features and Functionalities

The Heart Failure Care Plan enables care teams to record and manage:

Patient-Specific Heart Failure Details: Capture heart failure information on behalf of the patient.
Medication Management: View GP-contributed medication details and quickly access relevant information.
Assessment Findings: Document results and key findings over a course of assessments.
Progress Tracking: Monitor patient progress and update clinical management plans throughout their care journey.
Integrated Care Plans: Develop comprehensive care and support plans, including goal tracking, contingency planning, and End of Life (EPaCCS) records if applicable.
Key Care Contacts: Record personal and professional contacts essential for the patient’s care.
MDT Actions and Outcomes: Log actions and outcomes from Multi-Disciplinary Team (MDT) meetings.
Supporting Documentation: Upload images of care planning documents, such as ReSPECT forms.

Graphnet Heart Failure Care Plan is a vital tool in modern healthcare, ensuring better outcomes and streamlined processes for both patients and care teams.